Ryan White HIV/AIDS Program Client-Level Data Reporting System

Forms and Documents

Document	Type	Status	Availability
Form 3 Client Level Data on File	Form and Instruction	Modified	Available
Form 2 Provider Report	Form and Instruction	Unchanged	Available
Form 2 Provider Report	Form and Instruction	Unchanged	Repair queued
Form 1 Recipient Report	Form and Instruction	Unchanged	Available
Form 1 Recipient Report	Form and Instruction	Unchanged	Repair queued
HRSA HAB RSR Non-Substantive Change Memo _ OMB 0906 0039_ 06132025_v2.0_Draft_Final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-06-30	Available
HRSA HAB RSR Non-Substantive Change Memo _ OMB 0906 0039_ 06132025_v2.0_Draft_Final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-06-30	Repair queued
Tab A - 2009 RWHAP Legislation.pdf	Supplementary Document	Uploaded 2021-11-16	Available
Tab A - 2009 RWHAP Legislation.pdf	Supplementary Document	Uploaded 2021-11-16	Repair queued
Supporting Statement A - RSR 2024 Final 07012024.docx	Supporting Statement A	Uploaded 2024-07-16	Available
Supporting Statement A - RSR 2024 Final 07012024.docx	Supporting Statement A	Uploaded 2024-07-16	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
269447	Client Report	Form and Instruction	Modified	Client Level Data on File
269447	Client Report	Other-Redline	Modified
269446	Provider Report	Form and Instruction	Unchanged	Provider Report
269446	Provider Report	Form and Instruction	Unchanged
269445	Recipient Report	Form and Instruction	Unchanged	Recipient Report
269445	Recipient Report	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0906-0039	ICR Reference No: 202506-0906-004
Status: Active	Previous ICR Reference No: 202407-0906-003
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Ryan White HIV/AIDS Program Client-Level Data Reporting System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/03/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/02/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2027	09/30/2027	09/30/2027
Responses	4,190	0	4,190
Time Burden (Hours)	206,480	0	206,480
Cost Burden (Dollars)	0	0	0

---

Abstract: The Ryan White HIV/AIDS Program’s (RWHAP) client-level data reporting system, entitled the RWHAP Services Report or the Ryan White Services Report (RSR), is designed to collect information from grant recipients, as well as their subrecipients, funded under Parts A, B, C, and D of the RWHAP statute. The RWHAP, authorized under Title XXVI of the Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009, is administered by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB). The HRSA RWHAP funds and coordinates with cities, states, and local clinics/community-based organizations to deliver efficient and effective HIV care, treatment, and support to low-income people living with HIV (PLWH).

---

Authorizing Statute(s): PL: Pub.L. 111 - 87 0 Name of Law: Ryan White HIV/AIDS Treatment Extension Act of 2009
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 30384	04/24/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 57913	07/16/2024
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Client Report	3	Client Level Data on File
Provider Report	2	Provider Report
Recipient Report	1	Recipient Report

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,190	4,190	0	0	0	0
Annual Time Burden (Hours)	206,480	206,480	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $1,700,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/02/2025

---